{ "resourceType": "StructureDefinition", "id": "nexus-attachment-packet", "extension": [ { "url": "https://fhir.apps.health/StructureDefinition/effective-date", "extension": [ { "url": "none", "valueBoolean": true } ] }, { "url": "https://fhir.apps.health/StructureDefinition/smart-exposed", "extension": [ { "url": "read", "valueString": "list:read" }, { "url": "write", "valueString": "list:write" } ] } ], "url": "https://fhir.apps.health/StructureDefinition/nexus-attachment-packet", "name": "NexusAttachmentPacket", "title": "Attachment Packet Profile", "status": "draft", "publisher": "WELLSTAR Technologies Corp.", "description": "An **attachment packet**: the ordered set of chart items assembled to travel with an outbound\nartifact -- a letter today, an eReferral next, and forms, emails and chart prints after that.\n\nMembership and order are `List.entry`. The host points at the packet with the reference element it\nalready has: a letter uses one `Composition.section.entry`, a referral uses\n`ServiceRequest.supportingInfo`. Both are `Reference(Resource)` in base R4, so a packet is legal in\neach without a new element anywhere.\n\n**The packet is not the sent document.** It is the assembly. What the recipient received is the\nrendered file stored when the host is SENT, which carries a `Provenance` deriving it from this\nList **at the version it had** -- because membership, order and per-member exclusions all move.\n\n**A letter names its packets in one coded section.** A `Composition` profiled as\n[`nexus-emr-core-composition`](StructureDefinition-nexus-emr-core-composition.md) MAY carry a\nsection coded LOINC `28562-7` whose `entry` references packets; that is the only place a letter\nrecords what travels with it, and the `enclosures` slice on that profile is where the join is\ndeclared.\n\n**Two assembly facts ride beside the membership.** Whether the render leads with a generated cover\npage is the [`nexus-packet-cover-page`](StructureDefinition-nexus-packet-cover-page.md) extension,\ndeclared as the `coverPage` slice below -- read it before treating an absent value as `false`, which\nit is not. Which way out of the EMR the packet was built for is a `meta.tag` coding under\n[`nexus-send-channel`](CodeSystem-nexus-send-channel.md); this profile does not slice or otherwise\nconstrain `meta.tag`, because the element is open on every resource and that marker belongs to one\nproducer rather than to the shape every packet conforms to.\n\n**Neither of those records a send.** Both say what was chosen while the packet was being assembled.\nA channel tag is not evidence that anything was transmitted.", "fhirVersion": "4.0.1", "mapping": [ { "identity": "rim", "uri": "http://hl7.org/v3", "name": "RIM Mapping" }, { "identity": "w5", "uri": "http://hl7.org/fhir/fivews", "name": "FiveWs Pattern Mapping" } ], "kind": "resource", "abstract": false, "type": "List", "baseDefinition": "http://hl7.org/fhir/StructureDefinition/List", "derivation": "constraint", "snapshot": { "element": [ { "id": "List", "path": "List", "short": "Nexus EMR Attachment Packet", "definition": "A list is a curated collection of resources.", "alias": [ "Collection", "WorkingList", "Organizer" ], "min": 0, "max": "*", "base": { "path": "List", "min": 0, "max": "*" }, "constraint": [ { "key": "dom-2", "severity": "error", "human": "If the resource is contained in another resource, it SHALL NOT contain nested Resources", "expression": "contained.contained.empty()", "xpath": "not(parent::f:contained and f:contained)", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" }, { "key": "dom-3", "severity": "error", "human": "If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource", "expression": "contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()", "xpath": "not(exists(for $id in f:contained/*/f:id/@value return $contained[not(parent::*/descendant::f:reference/@value=concat('#', $contained/*/id/@value) or descendant::f:reference[@value='#'])]))", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" }, { "key": "dom-4", "severity": "error", "human": "If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated", "expression": "contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()", "xpath": "not(exists(f:contained/*/f:meta/f:versionId)) and not(exists(f:contained/*/f:meta/f:lastUpdated))", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" }, { "key": "dom-5", "severity": "error", "human": "If a resource is contained in another resource, it SHALL NOT have a security label", "expression": "contained.meta.security.empty()", "xpath": "not(exists(f:contained/*/f:meta/f:security))", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" }, { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice", "valueBoolean": true }, { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bestpractice-explanation", "valueMarkdown": "When a resource has no narrative, only systems that fully understand the data can display the resource to a human safely. Including a human readable representation in the resource makes for a much more robust eco-system and cheaper handling of resources by intermediary systems. Some ecosystems restrict distribution of resources to only those systems that do fully understand the resources, and as a consequence implementers may believe that the narrative is superfluous. However experience shows that such eco-systems often open up to new participants over time." } ], "key": "dom-6", "severity": "warning", "human": "A resource should have narrative for robust management", "expression": "text.`div`.exists()", "xpath": "exists(f:text/h:div)", "source": "http://hl7.org/fhir/StructureDefinition/DomainResource" }, { "key": "lst-1", "severity": "error", "human": "A list can only have an emptyReason if it is empty", "expression": "emptyReason.empty() or entry.empty()", "xpath": "not(exists(f:emptyReason) and exists(f:entry))" }, { "key": "lst-2", "severity": "error", "human": "The deleted flag can only be used if the mode of the list is \"changes\"", "expression": "mode = 'changes' or entry.deleted.empty()", "xpath": "(f:mode/@value = 'changes') or not(exists(f:entry/f:deleted))" }, { "key": "lst-3", "severity": "error", "human": "An entry date can only be used if the mode of the list is \"working\"", "expression": "mode = 'working' or entry.date.empty()", "xpath": "(f:mode/@value = 'working') or not(exists(f:entry/f:date))" }, { "key": "nexus-note-extension-not-where-native", "severity": "error", "human": "The resource-note extension is not used on a resource that has a native `note` element -- that element is the home", "expression": "extension('https://fhir.apps.health/StructureDefinition/nexus-emr-resource-note').empty()", "source": "https://fhir.apps.health/StructureDefinition/nexus-attachment-packet" }, { "key": "nexus-packet-has-identity", "severity": "error", "human": "A packet carries exactly one identifier under the Nexus attachment-packet naming system -- that identifier is which packet this is, and it is what a search for the packets on a chart finds.", "expression": "identifier.where(system = 'https://fhir.apps.health/NamingSystem/nexus-attachment-packet').count() = 1", "source": "https://fhir.apps.health/StructureDefinition/nexus-attachment-packet" }, { "key": "nexus-packet-members-distinct", "severity": "error", "human": "A resource appears at most once in a packet. Two entries naming the same resource make the packet's order ambiguous, and let one member carry two different sets of excluded pages.", "expression": "entry.item.reference.empty() or entry.item.reference.isDistinct()", "source": "https://fhir.apps.health/StructureDefinition/nexus-attachment-packet" }, { "key": "nexus-packet-excluded-pages-are-positive", "severity": "error", "human": "An excluded page number is 1-based and therefore at least 1. A zero or negative value is a producer defect, not an edge case: it names no page, and a renderer that ignores it drops a page the assembler meant to keep.", "expression": "entry.extension.where(url = 'https://fhir.apps.health/StructureDefinition/nexus-attachment-packet-excluded-page').all(value.ofType(integer) >= 1)", "source": "https://fhir.apps.health/StructureDefinition/nexus-attachment-packet" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "Entity. Role, or Act" }, { "identity": "rim", "map": "Act[classCode id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true }, { "id": "List.implicitRules", "path": "List.implicitRules", "short": "A set of rules under which this content was created", "definition": "A reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Often, this is a reference to an implementation guide that defines the special rules along with other profiles etc.", "comment": "Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. Often, when used, the URL is a reference to an implementation guide that defines these special rules as part of it's narrative along with other profiles, value sets, etc.", "min": 0, "max": "1", "base": { "path": "Resource.implicitRules", "min": 0, "max": "1" }, "type": [ { "code": "uri" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": true, "isModifierReason": "This element is labeled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation", "isSummary": true }, { "id": "List.language", "path": "List.language", "short": "Language of the resource content", "definition": "The base language in which the resource is written.", "comment": "Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource. Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute).", "min": 0, "max": "1", "base": { "path": "Resource.language", "min": 0, "max": "1" }, "type": [ { "code": "code" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": false, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-maxValueSet", "valueCanonical": "http://hl7.org/fhir/ValueSet/all-languages" }, { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "Language" }, { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-isCommonBinding", "valueBoolean": true } ], "strength": "preferred", "description": "A human language.", "valueSet": "http://hl7.org/fhir/ValueSet/languages" } }, { "id": "List.text", "path": "List.text", "short": "Text summary of the resource, for human interpretation", "definition": "A human-readable narrative that contains a summary of the resource and can be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it \"clinically safe\" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety.", "comment": "Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a \"text blob\" or where text is additionally entered raw or narrated and encoded information is added later.", "alias": [ "narrative", "html", "xhtml", "display" ], "min": 0, "max": "1", "base": { "path": "DomainResource.text", "min": 0, "max": "1" }, "type": [ { "code": "Narrative" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "Act.text?" } ] }, { "id": "List.contained", "path": "List.contained", "short": "Contained, inline Resources", "definition": "These resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope.", "comment": "This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again. Contained resources may have profiles and tags In their meta elements, but SHALL NOT have security labels.", "alias": [ "inline resources", "anonymous resources", "contained resources" ], "min": 0, "max": "*", "base": { "path": "DomainResource.contained", "min": 0, "max": "*" }, "type": [ { "code": "Resource" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "List.extension", "path": "List.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "ordered": false, "rules": "open" }, "short": "Additional content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.", "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "DomainResource.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "List.extension:coverPage", "path": "List.extension", "sliceName": "coverPage", "short": "Does the render lead with a generated cover page? (absent = not stated, NOT false)", "definition": "May be used to represent additional information that is not part of the basic definition of the resource. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.", "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.", "alias": [ "extensions", "user content" ], "min": 0, "max": "1", "base": { "path": "DomainResource.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension", "profile": [ "https://fhir.apps.health/StructureDefinition/nexus-packet-cover-page" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "mustSupport": true, "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "List.modifierExtension", "path": "List.modifierExtension", "short": "Extensions that cannot be ignored", "definition": "May be used to represent additional information that is not part of the basic definition of the resource and that modifies the understanding of the element that contains it and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).", "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.", "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "DomainResource.modifierExtension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": true, "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the resource that contains them", "isSummary": false, "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "List.identifier", "path": "List.identifier", "short": "Stable identity of this packet, and the marker that this List is one", "definition": "Identifier for the List assigned for business purposes outside the context of FHIR.", "min": 1, "max": "*", "base": { "path": "List.identifier", "min": 0, "max": "*" }, "type": [ { "code": "Identifier" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": false, "mapping": [ { "identity": "w5", "map": "FiveWs.identifier" }, { "identity": "rim", "map": ".id" } ] }, { "id": "List.status", "path": "List.status", "short": "current (live assembly) | retired (superseded) | entered-in-error", "definition": "Indicates the current state of this list.", "comment": "This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.", "min": 1, "max": "1", "base": { "path": "List.status", "min": 1, "max": "1" }, "type": [ { "code": "code" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": true, "isModifierReason": "This element is labeled as a modifier because it is a status element that contains status entered-in-error which means that the resource should not be treated as valid", "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "ListStatus" } ], "strength": "required", "description": "The current state of the list.", "valueSet": "http://hl7.org/fhir/ValueSet/list-status|4.0.1" }, "mapping": [ { "identity": "w5", "map": "FiveWs.status" }, { "identity": "rim", "map": ".status[current=active;retired=obsolete;entered-in-error=nullified]" } ] }, { "id": "List.mode", "path": "List.mode", "short": "working | snapshot | changes", "definition": "How this list was prepared - whether it is a working list that is suitable for being maintained on an ongoing basis, or if it represents a snapshot of a list of items from another source, or whether it is a prepared list where items may be marked as added, modified or deleted.", "comment": "This element is labeled as a modifier because a change list must not be misunderstood as a complete list.", "requirements": "Lists are used in various ways, and it must be known in what way it is safe to use them.", "min": 1, "max": "1", "base": { "path": "List.mode", "min": 1, "max": "1" }, "type": [ { "code": "code" } ], "fixedCode": "working", "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": true, "isModifierReason": "If set to \"changes\", the list is considered incomplete, while the other two codes indicate the list is complete, which changes the understanding of the elements listed", "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "ListMode" } ], "strength": "required", "description": "The processing mode that applies to this list.", "valueSet": "http://hl7.org/fhir/ValueSet/list-mode|4.0.1" }, "mapping": [ { "identity": "w5", "map": "FiveWs.class" }, { "identity": "rim", "map": ".outBoundRelationship[typeCode=COMP].target[classCode=OBS\"].value" } ] }, { "id": "List.title", "path": "List.title", "short": "The packet's name, as shown where it is assembled and reviewed", "definition": "A human-readable name for this assembly, shown in the attachment surface that built it and beside the record of what was sent. Names the packet's purpose rather than its members (\"Enclosures - Internal Medicine referral letter\"), because membership is `entry` and changes while the packet is being assembled.", "requirements": "Allows customization beyond just the code identifying the kind of list.", "min": 1, "max": "1", "base": { "path": "List.title", "min": 0, "max": "1" }, "type": [ { "code": "string" } ], "example": [ { "label": "General", "valueString": "Dr. Jane's Patients" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "rim", "map": ".title" } ] }, { "id": "List.code", "path": "List.code", "short": "What the purpose of this list is", "definition": "This code defines the purpose of the list - why it was created.", "comment": "If there is no code, the purpose of the list is implied where it is used, such as in a document section using Document.section.code.", "requirements": "Lists often contain subsets of resources rather than an exhaustive list. The code identifies what type of subset is included.", "min": 0, "max": "1", "base": { "path": "List.code", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "ListPurpose" } ], "strength": "example", "description": "What the purpose of a list is.", "valueSet": "http://hl7.org/fhir/ValueSet/list-example-codes" }, "mapping": [ { "identity": "w5", "map": "FiveWs.what[x]" }, { "identity": "rim", "map": ".code" } ] }, { "id": "List.subject", "path": "List.subject", "short": "The patient whose chart these items came from", "definition": "The common subject (or patient) of the resources that are in the list if there is one.", "comment": "Some purely arbitrary lists do not have a common subject, so this is optional.", "requirements": "The primary purpose of listing the subject explicitly is to help with finding the right list.", "min": 1, "max": "1", "base": { "path": "List.subject", "min": 0, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": [ "https://fhir.apps.health/StructureDefinition/nexus-emr-core-patient" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": true, "mapping": [ { "identity": "w5", "map": "FiveWs.subject[x]" }, { "identity": "rim", "map": ".participation[typeCode id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "w5", "map": "FiveWs.context" }, { "identity": "rim", "map": "inboundRelationship[typeCode=COMP].source[classCode=ENC, moodCode=EVN]" } ] }, { "id": "List.date", "path": "List.date", "short": "When the list was prepared", "definition": "The date that the list was prepared.", "comment": "The actual important date is the date of currency of the resources that were summarized, but it is usually assumed that these are current when the preparation occurs.", "requirements": "Identifies how current the list is which affects relevance.", "min": 0, "max": "1", "base": { "path": "List.date", "min": 0, "max": "1" }, "type": [ { "code": "dateTime" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "w5", "map": "FiveWs.recorded" }, { "identity": "rim", "map": ".participation[typeCode id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": true, "mapping": [ { "identity": "w5", "map": "FiveWs.author" }, { "identity": "rim", "map": ".participation[typeCode id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": false, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "ListOrder" } ], "strength": "preferred", "description": "What order applies to the items in a list.", "valueSet": "http://hl7.org/fhir/ValueSet/list-order" }, "mapping": [ { "identity": "rim", "map": ".outboundRelationship[typeCode=COMP].sequenceNumber > 1" } ] }, { "id": "List.note", "path": "List.note", "short": "Comments about the list", "definition": "Comments that apply to the overall list.", "min": 0, "max": "*", "base": { "path": "List.note", "min": 0, "max": "*" }, "type": [ { "code": "Annotation" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": ".inboundRelationship[typeCode=SUBJ].act.text" } ] }, { "id": "List.entry", "path": "List.entry", "short": "The members, in order", "definition": "One member of the packet. `List.entry` is ORDERED, and the order is the order the members appear in\nthe outbound render.\n\n`entry.item` is deliberately unconstrained as to resource type: the packet carries what a clinician\nchose to send, and enumerating the types would reintroduce the per-type modelling this profile\nexists to replace. A consumer renders the kinds it knows and reports the ones it does not, rather\nthan dropping them silently.\n\nAn entry MAY carry `nexus-attachment-packet-excluded-page` extensions naming pages of that member\nthe assembler left out.", "comment": "If there are no entries in the list, an emptyReason SHOULD be provided.", "min": 1, "max": "*", "base": { "path": "List.entry", "min": 0, "max": "*" }, "type": [ { "code": "BackboneElement" } ], "condition": [ "lst-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": ".outboundRelationship[typeCode=COMP] or .participation[typeCode=SBJ]" } ] }, { "id": "List.entry.id", "path": "List.entry.id", "representation": [ "xmlAttr" ], "short": "Unique id for inter-element referencing", "definition": "Unique id for the element within a resource (for internal references). This may be any string value that does not contain spaces.", "min": 0, "max": "1", "base": { "path": "Element.id", "min": 0, "max": "1" }, "type": [ { "code": "http://hl7.org/fhirpath/System.String", "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fhir-type", "valueUrl": "string" } ] } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "List.entry.extension", "path": "List.entry.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "ordered": false, "rules": "open" }, "short": "Additional content defined by implementations", "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.", "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "List.entry.extension:excludedPage", "path": "List.entry.extension", "sliceName": "excludedPage", "short": "A page of this member excluded from the render (1-based; repeats)", "definition": "May be used to represent additional information that is not part of the basic definition of the element. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension.", "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.", "alias": [ "extensions", "user content" ], "min": 0, "max": "*", "base": { "path": "Element.extension", "min": 0, "max": "*" }, "type": [ { "code": "Extension", "profile": [ "https://fhir.apps.health/StructureDefinition/nexus-attachment-packet-excluded-page" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": "n/a" } ] }, { "id": "List.entry.modifierExtension", "path": "List.entry.modifierExtension", "short": "Extensions that cannot be ignored even if unrecognized", "definition": "May be used to represent additional information that is not part of the basic definition of the element and that modifies the understanding of the element in which it is contained and/or the understanding of the containing element's descendants. Usually modifier elements provide negation or qualification. To make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer can define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions.\n\nModifier extensions SHALL NOT change the meaning of any elements on Resource or DomainResource (including cannot change the meaning of modifierExtension itself).", "comment": "There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.", "requirements": "Modifier extensions allow for extensions that *cannot* be safely ignored to be clearly distinguished from the vast majority of extensions which can be safely ignored. This promotes interoperability by eliminating the need for implementers to prohibit the presence of extensions. For further information, see the [definition of modifier extensions](extensibility.html#modifierExtension).", "alias": [ "extensions", "user content", "modifiers" ], "min": 0, "max": "*", "base": { "path": "BackboneElement.modifierExtension", "min": 0, "max": "*" }, "type": [ { "code": "Extension" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" }, { "key": "ext-1", "severity": "error", "human": "Must have either extensions or value[x], not both", "expression": "extension.exists() != value.exists()", "xpath": "exists(f:extension)!=exists(f:*[starts-with(local-name(.), \"value\")])", "source": "http://hl7.org/fhir/StructureDefinition/Extension" } ], "isModifier": true, "isModifierReason": "Modifier extensions are expected to modify the meaning or interpretation of the element that contains them", "isSummary": true, "mapping": [ { "identity": "rim", "map": "N/A" } ] }, { "id": "List.entry.flag", "path": "List.entry.flag", "short": "Status/Workflow information about this item", "definition": "The flag allows the system constructing the list to indicate the role and significance of the item in the list.", "comment": "The flag can only be understood in the context of the List.code. If the flag means that the entry has actually been deleted from the list, the deleted element SHALL be true. Deleted can only be used if the List.mode is \"changes\".", "requirements": "This field is present to support various clinical uses of lists, such as a discharge summary medication list, where flags specify whether the medication was added, modified, or deleted from the list.", "min": 0, "max": "1", "base": { "path": "List.entry.flag", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": false, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "ListItemFlag" } ], "strength": "example", "description": "Codes that provide further information about the reason and meaning of the item in the list.", "valueSet": "http://hl7.org/fhir/ValueSet/list-item-flag" }, "mapping": [ { "identity": "rim", "map": ".outBoundRelationship[typeCode=COMP].target[classCode=OBS\"].value" } ] }, { "id": "List.entry.deleted", "path": "List.entry.deleted", "short": "If this item is actually marked as deleted", "definition": "True if this item is marked as deleted in the list.", "comment": "If the flag means that the entry has actually been deleted from the list, the deleted element SHALL be true. Both flag and deleted can only be used if the List.mode is \"changes\". A deleted entry should be displayed in narrative as deleted. This element is labeled as a modifier because it indicates that an item is (to be) no longer in the list.", "requirements": "The flag element may contain codes that an application processing the list does not understand. However there can be no ambiguity if a list item is actually marked as \"deleted\".", "min": 0, "max": "1", "base": { "path": "List.entry.deleted", "min": 0, "max": "1" }, "type": [ { "code": "boolean" } ], "meaningWhenMissing": "List items are generally only treated as deleted when this element explicitly carries a value of true. Systems SHOULD always populate this value when mode is 'changes'", "condition": [ "lst-2" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": true, "isModifierReason": "If deleted is true, then the item included in the list isn't actually part of the list anymore", "isSummary": false, "mapping": [ { "identity": "rim", "map": "added: .updateMode=(\"A\",\"AR\") retained: .updateMode=\"NC\" updated: .updateMode=\"R\" deleted: .updateMode=\"D\"" } ] }, { "id": "List.entry.date", "path": "List.entry.date", "short": "When item added to list", "definition": "When this item was added to the list.", "requirements": "The date may be significant for understanding the meaning of items in a working list.", "min": 0, "max": "1", "base": { "path": "List.entry.date", "min": 0, "max": "1" }, "type": [ { "code": "dateTime" } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": ".availabilityTime" } ] }, { "id": "List.entry.item", "path": "List.entry.item", "short": "The chart item -- a document, note, result or form; SHALL be about this packet's subject", "definition": "A reference to the actual resource from which data was derived.", "comment": "**Every member SHALL be about the patient in `List.subject`.** A packet is assembled from one\nchart and travels to an external recipient, so a member belonging to a different patient is\ncross-patient disclosure at the moment the host is sent.\n\n**No validator enforces this, and that is a limitation to design around rather than a gap to\nignore.** FHIRPath cannot resolve a reference, so the rule is not expressible as an invariant, and\n`entry.item` is deliberately `Reference(Resource)` so no type constraint narrows it either. A\npacket naming another patient's document is therefore structurally valid. Enforcement belongs where\nthe write happens and the reference can be resolved: a server accepting a packet SHALL reject a\nmember whose subject is not the packet's subject.\n\nA consumer that did not assemble the packet should not assume the rule held: resolve the members\nand check, rather than trusting `List.subject` to describe all of them.", "min": 1, "max": "1", "base": { "path": "List.entry.item", "min": 1, "max": "1" }, "type": [ { "code": "Reference", "targetProfile": [ "http://hl7.org/fhir/StructureDefinition/Resource" ] } ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "mustSupport": true, "isModifier": false, "isSummary": false, "mapping": [ { "identity": "rim", "map": ".target or .role or .role.entity" } ] }, { "id": "List.emptyReason", "path": "List.emptyReason", "short": "Why list is empty", "definition": "If the list is empty, why the list is empty.", "comment": "The various reasons for an empty list make a significant interpretation to its interpretation. Note that this code is for use when the entire list has been suppressed, and not for when individual items are omitted - implementers may consider using a text note or a flag on an entry in these cases.", "requirements": "Allows capturing things like \"none exist\" or \"not asked\" which can be important for most lists.", "min": 0, "max": "1", "base": { "path": "List.emptyReason", "min": 0, "max": "1" }, "type": [ { "code": "CodeableConcept" } ], "condition": [ "lst-1" ], "constraint": [ { "key": "ele-1", "severity": "error", "human": "All FHIR elements must have a @value or children", "expression": "hasValue() or (children().count() > id.count())", "xpath": "@value|f:*|h:div", "source": "http://hl7.org/fhir/StructureDefinition/Element" } ], "isModifier": false, "isSummary": false, "binding": { "extension": [ { "url": "http://hl7.org/fhir/StructureDefinition/elementdefinition-bindingName", "valueString": "ListEmptyReason" } ], "strength": "preferred", "description": "If a list is empty, why it is empty.", "valueSet": "http://hl7.org/fhir/ValueSet/list-empty-reason" }, "mapping": [ { "identity": "rim", "map": ".inboundRelationship[typeCode=SUBJ,code= 1)", "source": "https://fhir.apps.health/StructureDefinition/nexus-attachment-packet" } ] }, { "id": "List.extension", "path": "List.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "ordered": false, "rules": "open" } }, { "id": "List.extension:coverPage", "path": "List.extension", "sliceName": "coverPage", "short": "Does the render lead with a generated cover page? (absent = not stated, NOT false)", "min": 0, "max": "1", "type": [ { "code": "Extension", "profile": [ "https://fhir.apps.health/StructureDefinition/nexus-packet-cover-page" ] } ], "mustSupport": true }, { "id": "List.identifier", "path": "List.identifier", "short": "Stable identity of this packet, and the marker that this List is one", "min": 1, "mustSupport": true }, { "id": "List.status", "path": "List.status", "short": "current (live assembly) | retired (superseded) | entered-in-error", "mustSupport": true }, { "id": "List.mode", "path": "List.mode", "fixedCode": "working" }, { "id": "List.title", "path": "List.title", "short": "The packet's name, as shown where it is assembled and reviewed", "definition": "A human-readable name for this assembly, shown in the attachment surface that built it and beside the record of what was sent. Names the packet's purpose rather than its members (\"Enclosures - Internal Medicine referral letter\"), because membership is `entry` and changes while the packet is being assembled.", "min": 1, "mustSupport": true }, { "id": "List.subject", "path": "List.subject", "short": "The patient whose chart these items came from", "min": 1, "type": [ { "code": "Reference", "targetProfile": [ "https://fhir.apps.health/StructureDefinition/nexus-emr-core-patient" ] } ], "mustSupport": true }, { "id": "List.entry", "path": "List.entry", "short": "The members, in order", "definition": "One member of the packet. `List.entry` is ORDERED, and the order is the order the members appear in\nthe outbound render.\n\n`entry.item` is deliberately unconstrained as to resource type: the packet carries what a clinician\nchose to send, and enumerating the types would reintroduce the per-type modelling this profile\nexists to replace. A consumer renders the kinds it knows and reports the ones it does not, rather\nthan dropping them silently.\n\nAn entry MAY carry `nexus-attachment-packet-excluded-page` extensions naming pages of that member\nthe assembler left out.", "min": 1, "mustSupport": true }, { "id": "List.entry.extension", "path": "List.entry.extension", "slicing": { "discriminator": [ { "type": "value", "path": "url" } ], "ordered": false, "rules": "open" } }, { "id": "List.entry.extension:excludedPage", "path": "List.entry.extension", "sliceName": "excludedPage", "short": "A page of this member excluded from the render (1-based; repeats)", "min": 0, "max": "*", "type": [ { "code": "Extension", "profile": [ "https://fhir.apps.health/StructureDefinition/nexus-attachment-packet-excluded-page" ] } ] }, { "id": "List.entry.item", "path": "List.entry.item", "short": "The chart item -- a document, note, result or form; SHALL be about this packet's subject", "comment": "**Every member SHALL be about the patient in `List.subject`.** A packet is assembled from one\nchart and travels to an external recipient, so a member belonging to a different patient is\ncross-patient disclosure at the moment the host is sent.\n\n**No validator enforces this, and that is a limitation to design around rather than a gap to\nignore.** FHIRPath cannot resolve a reference, so the rule is not expressible as an invariant, and\n`entry.item` is deliberately `Reference(Resource)` so no type constraint narrows it either. A\npacket naming another patient's document is therefore structurally valid. Enforcement belongs where\nthe write happens and the reference can be resolved: a server accepting a packet SHALL reject a\nmember whose subject is not the packet's subject.\n\nA consumer that did not assemble the packet should not assume the rule held: resolve the members\nand check, rather than trusting `List.subject` to describe all of them.", "mustSupport": true } ] } }